An Interview with Michael Edelstein, Ph.D., on Rational Emotive Behavior Therapy
David Van Nuys, Ph.D. Updated: Mar 15th 2011
Michael R. Edelstein, Ph.D., a Clinical Psychologist and REBT therapist is a protogee of Dr. Albert Ellis, one of the key founders of the modern cognitive behavioral therapy movement. Though today largely overshadowed by Dr. Aaron Beck, Ellis described the basic ideas that continue to inform cognitive behavioral therapy (CBT) years before Beck started down that path. Dr. Edelstein's book Three Minute Therapist is a restatement of Ellis' important ideas for non-therapists who are interested in using these techniques as a mode of self-help. The REBT scheme is often described as the ABC theory, where A stands for an activating event, B for an irrational belief brought to mind by the event, and C for the undesirable emotional and behavioral consequences that stem from the irrational belief. The application of REBT (and all cognitive therapies) is designed to help people identify their irrational beliefs and then scrutinize and dispute them to see if they are based on anything substantial. As irrational beliefs are identified as faulty, their power to motivate sadness and anxiety lessens and people start to feel better. Regular practice of the ABC technique can help people to overcome their mood issues. In addition to clearly describing the REBT disputing process, Dr. Edelstein also uses the interview to discuss the demanding, global and polarizing nature of irrational beliefs (things must be all good or they are all bad), and the trap of high self-esteem. A critic of Alcoholics Anonymous, Dr. Edelstein helps coordinate SMART Recovery, an alternative self-help program for alcoholics based on rational principles.
David Van Nuys: Welcome to Wise Counsel, a podcast interview series sponsored by Mentalhelp.net, covering topics in mental health, wellness, and psychotherapy. My name is Dr. David Van Nuys. I'm a clinical psychologist and your host.
On today's show, we'll be talking with Dr. Michael Edelstein about his work with rational emotive behavior therapy or REBT. Michael R. Edelstein, Ph.D., is a clinical psychologist. He has both an in-person and telephone therapy practice. Dr. Edelstein has appeared on over 300 radio shows, lectures regularly, and trains professionals. He was awarded Author of the Year by the National Association of Behavior and Cognitive Therapists for his 1997 book, Three Minute Therapy. Dr. Edelstein is also a past president of the Association of Behavior and Cognitive Therapists. In addition, he trains volunteers at the National Save-A-Life League and Community Sex Information, both in New York City. He is also the professional advisor for SMART Recovery, an addiction self-help group in San Francisco. You can find more information about Dr. Edelstein and rational emotive behavior therapy at www.threeminutetherapy.com.
Now, here's the interview.
Dr. Michael Edelstein, welcome to Wise Counsel.
Michael Edelstein: Thank you, Dave. Thanks for inviting me.
David: It's great to have this opportunity to speak with you. I understand you first discovered Albert Ellis and his rational emotive therapy when you were just 19 years old. How did that come about?
Michael Edelstein: Well, when I was 18, I was depressed most of the time and anxious the rest of the time. I was very insecure, procrastinated on schoolwork, practically got thrown out of college for not studying for exams. And then I tried therapy, and I was seeing a psychoanalytically oriented therapist, and he was a very nice, warm guy. I always looked forward to the sessions. However, I never got any suggestions or advice or counsel in terms of how I could overcome my problems. He just had me talk and said things like, "Tell me more," or "Why do you feel that way?" And then after a year of that, I heard Albert Ellis on the radio and went to a lecture of his, and he was very forward about criticizing psychoanalysis and psychoanalytically-oriented therapy, and his criticism made a lot of sense to me, so I immediately started to see him at 19 years old, and that dramatically changed my life.
David: Wow. Now, were you in college at the time that you were seeing him?
Michael Edelstein: Yeah, I was in college at the time, and as I mentioned, Dave, I had failed a number of courses because I wasn't studying for exams due to my procrastination problem, and I was on the verge of getting kicked out of college, and then fortunately I started to see him, and he helped me with all that.
David: Let me just back up here. What more can you tell us about your educational background? I gather you went on; you got a Ph.D. Tell us how that happened, where you went to school, etc.
Michael Edelstein: When I started seeing Albert Ellis, I saw him individually for about six months and in his group therapy for a few years. And I really liked helping other people in the group using his ideas, and then I started to help my friends and relatives using what's now called rational emotive behavior therapy or REBT. And I thought, well, this is the field for me - become a therapist and help people. And I did, and that's how I became a psychologist.
David: Yeah. Where did you get your Ph.D.?
Michael Edelstein: I lived in New York most of my life. Now I'm in San Francisco, and I got my Ph.D. at Yeshiva University in New York City.
David: Okay, and before we get into your work, what should listeners know about Albert Ellis? You want to tell us just a little bit more?
Michael Edelstein: Yes. Albert Ellis was, as far as I'm concerned and many people in the field, was a genius in the field of psychology - one of the few geniuses in this area in the 20th century. He was a psychoanalyst in his early years of doing therapy, and he found that very ineffective. And then he devised, himself, this approach - rational emotive behavior therapy - which has spawned many of the cognitive behavior therapies that are popular. And in 1955, he came out with his first paper on REBT, and these days it's a very popular form of therapy.
In fact, when I was a graduate student and started therapy with Ellis and was familiar with REBT and I spoke to psychologists about this approach, they had all kinds of criticisms: it's too intellectual, and it doesn't really - it's not deep enough, and things like that. But these days, when I tell people, psychologists, I do REBT, I never get that reaction. I get a very different reaction. Often they say, "Oh, I do some of that," or "Oh, Albert Ellis. Yeah, he's really good," and those kinds of things. So he dramatically revolutionized the field of psychotherapy as a result of his bold approach and also his assertive manner in getting the word out, giving lectures. Even though he was widely panned and discredited and reviled, he kept on. He was a very good role model for his approach, and I owe my profession and my good life to him.
David: Okay. He was assertive. I did get to hear him myself, and as you point out, he's one of the pioneers of what is today a very dominant approach known as CBT or cognitive behavioral therapy, which is the dominant paradigm these days. Do you think he gets enough credit for his contributions to CBT?
Michael Edelstein: That's a very good question, Dave, because I don't. And I'm continually dismayed when I see, in print or here, psychologists speak of CBT and they often credit it to Aaron Beck, who followed Ellis by about seven or eight years. Aaron Beck's first writing came out in 1962 or '63, and as I mentioned, Ellis came before him in about 1955. So Beck gets a lot of the credit, although Albert Ellis really was the one who devised this and got the word out, and Aaron Beck did some studying with Albert Ellis.
David: I saw in Wikipedia that Dr. Ellis died in 1997. Aside from the way that some of his key ideas have been absorbed by the CBT movement, how is rational emotive therapy faring as a separate approach? Do you think it will survive into the future as a separate, distinctive approach? Or is it just sort of getting absorbed by CBT?
Michael Edelstein: That's a good question. I think there'll probably always be a small contingent, like there is now, of REBT therapists, but it is to a large extent getting absorbed into CBT, and most notably at the Albert Ellis Institute in New York, they seem to be moving away from REBT more into CBT.
David: Well, that's all fascinating. As I mentioned, I had an opportunity to hear Dr. Ellis give a presentation at a conference when I was in graduate school, and at the time, his ideas certainly made sense to me and led me to read several of his books. But let's talk about your own work. I've been reading your book, Three Minute Therapy. That's a very provocative title, I must say. What's behind that title?
Michael Edelstein: Well, there are a few things behind that title. I was looking for a catchy title and a provocative title to get people's attention.
Michael Edelstein: And that was very effective because I've done over 300 radio and Internet interviews, and one of the first questions I'm asked is, "You mean you can really do therapy in three minutes?" or "You can get over your problems in three minutes?" or "What do you mean by three-minute therapy?" So it's been very helpful as a hook to get people interviewing me into the topic. So that was one meaning of it - just as a marketing ploy.
And then the other meaning of it is it refers to the three-minute exercises that I describe in my book that you do yourself, and the purpose of the book is to teach you to be your own therapist, and one of the main ways you do it is by doing the three-minute exercises every day, and that really encapsulates the three-minute therapy approach or the REBT approach or the cognitive behavior therapy approach, all very similar, and gets you over your problems by practicing it on a regular basis.
David: Okay. Now, I know that Ellis talked about what he called his ABC model, and I see in your book that you're talking about an ABCDE model. Is that your own extension of his ideas? Or did he later add that?
Michael Edelstein: Well, it's really just a re-labeling of his ideas, and I'd like to say that everything in my book, Three Minute Therapy, comes from Albert Ellis. Nothing is very original in there. I just try to explain it and elaborate in a very clear, concise way; however, it's all from Albert Ellis - and as is the three-minute exercise, so I have ABCDEF. Albert Ellis used a few different letters, but it's same thing, really, and I feel it's very clear exposition of Albert Ellis's ABC theory.
David: Okay. Well, I appreciate your candor and your forthrightness. I think too many authors would probably not give as much credit as you just did to Albert Ellis and his work. But take us through that model: ABCDEF. Tell us what each of those letters stand for.
Michael Edelstein: Okay. That's a good question, Dave, and let me do that with an example. So let's suppose you're a single man and you want to meet a woman, and you see an attractive woman on the street. And I recommend to my single clients all the time that one of the best ways to meet people is just if you see someone who looks interesting to talk to them. The worst that can happen is they're not interested.
So let's suppose you avoid doing that because you're afraid of rejection, so that set's up the problem. So at A, A stands for Activating Event: I see an attractive woman I'd like to speak to, but she might reject me. So A is the situation, the event, the adverse issue that might come up: I see an attractive woman that I'd like to talk to, but she might reject me.
B is your Irrational Belief, because it's not A - the possibility of rejection - that forces you to get anxious and avoid talking to her; but rather it's B: I must not be rejected, and if I am, this proves I'm a worthless loser. So it's B stands for Irrational Belief, what you tell yourself about the rejection. That leads to C: Undesirable Emotional and Behavioral Consequence, which is anxiety and avoidance. So A, B, and C pretty much summarizes the problem. A is possible rejection; B, I must not get rejected; C, anxiety and avoidance.
David: Okay, so let's hear about D, E, and F.
Michael Edelstein: So D, E, and F is dealing with the problem. Now, I want to mention that at B - I must not get rejected - we call that an irrational belief not because of your goal to avoid rejection. That's not irrational at all; that's a very rational goal - to avoid rejection. We call it an irrational belief because of the "must," the absolute, the dire necessity that you not get rejected, so we want to get rid of the "mustness" of your goal and just keep the goal to avoid rejection. So to do that, we go on to D. D stands for Disputing or Questioning the Irrational Belief, and that's a simple process. You just take what you have at B - I must not get rejected - and then put "Why?" in front of it, so at D we have "Why must I not be rejected?"
And then we go on to E. E stands for Effective New Thinking or the answer to the question, so if you think about it, there are no "musts," there are no absolutes, just our human preferences. So at E would be "There's no reason I absolutely must not get rejected, although I'd prefer not to get rejected. If I am rejected, this would be disadvantageous and unfortunate, but not the end of the universe. I've been rejected before and I've survived, and I'll survive it in the future. I don't like being rejected, but I definitely can stand what I don't like. If the woman I approach doesn't like me, this only consists of her thoughts in her head, and her thoughts can't magically diminish my worth as a person. All it proves at the very worst is I'm an imperfect human who acts imperfectly, not a worthless loser. I can still have a happy life, even if I'm rejected a hundred times, although I'd be happier if I'm accepted. The more I push myself to risk rejection, the more acceptances I'll get in the long run."
So E are statements that reject and negate the "must." There's no "must," there's no "half to's," just our preferences. And then once you internalize what you have at E, a more realistic way of looking at things, then that causes F. F is a new feeling and behavior which is concerned about rejection, not anxiety, and pushing myself to talk to the woman rather than avoiding it.
David: Great. Thanks for taking us through that. And my recollection of my readings in Ellis was that that B step, that irrational belief, is often - people don't recognize it. It's somehow automatic to the extent of perhaps being unconscious.
Michael Edelstein: That's right. That's a good point, Dave, that irrational beliefs - musts and shoulds and self-doubting and awfulizing - often are - people are unaware of them. They're not quite unconscious because often when I talk to them in the first session, they're phrasing things in terms of "I shouldn't be rejected," or "I have to do better," or "I must get this job," or "I can't possibly lose a job" - things like that. So they're actually saying these things, but they don't hear what they're saying, and they're not attuned to looking for shoulds and musts and self-doubting, so they're not really quite aware of what they're doing. But when I point it out to them in the first session, they pretty quickly start identifying it themselves, so I wouldn't quite call it unconscious. I think a better term might be just something they're not quite aware of.
David: Um-hmm. Okay. Now you also talk about the importance of what you call the problem separation technique. What are you referring to there?
Michael Edelstein: Well, the problem separation technique says, as we go through life and through our day, we have various goals: large goals, like to get a good job or to have a fulfilling relationship and a family; or even small goals, to get out of bed at 6:00 a.m. when the alarm goes off so I'm not late for work. And then these goals imply preferences: I'd prefer to have a fulfilling relationship; I'd prefer to get out of bed when the alarm goes off; I prefer not to be late for work.
So we have those preferences, and those preferences lead to practical problems such as how do I get myself out of bed at 6:00 a.m. when the alarm goes off rather than not hit the snooze button and sleep some more, or how do I find the fulfilling relationship or make relationships work. So we have various practical problems. But then, being imperfect humans, we often escalate these practical problems into emotional problems. So, when the alarm goes off, I get depressed and dread facing the day, or I get anxious about the possibility of being late. So the problem separation technique says we have practical problems and often we have emotional problems about that.
And the reason why it's useful to ask ourselves what's my practical problem here, and what's my emotional problem - my practical problem is how do I make sure I don't hit the snooze alarm when it goes off, and my emotional problem is getting anxious about being late - the reason why it's useful to separate those two kinds of problems is because when we identify the emotional problem, like the anxiety, we use emotional problem solving strategies to address that - like the three-minute exercise which I just demonstrated.
But when we identify the practical problem, then we use practical problem solving strategies, and each type is very different, and most people don't use the problem separation technique, so they often try to address their emotional problems with practical problem solving strategies, and that's why they continually fail, because they're using the wrong types of solutions for the wrong types of problems. So we usually start with the problem separation technique in asking, "What's the practical problem here and what's the emotional problem?"
David: Okay. I'm not sure if you've been following the positive psychology movement, which has a lot to say about happiness. I notice that you emphasize the role of preferences versus demands in the quest for happiness. Maybe you can tell us a little bit about that.
Michael Edelstein: Yes, and that's really the core of this whole approach, which is giving up your demands - your musts and shoulds - and getting in touch with your preferences and acting on those. So the theory here is that whenever you're emotionally disturbed or behaviorally destructive to yourself, you have some demand, some must or should.
And there are only three main musts or shoulds that people have, and the first one is a demand on oneself, and that takes the form of "I must do well and get approval, and if I don't, I'm no good." That leads to anxiety, depression, guilt, shame, embarrassment, jealousy, and hurt. The second demand is a demand on others: "You must treat me kindly, considerately, loving, courteously, fairly. And if you don't, you're no good." And that leads to resentment, hostility, rage, and anger.
And then the third must - it's not a demand on oneself or others; it's a demand on the impersonal conditions of one's life, and that takes the form of "Life must be fair, easy, and hassle-free, and if it's not, that's horrible, and I'll be miserable forever, so I might as well put uncomfortable things off or escape into drugs or alcohol." And that leads to addictions and procrastination.
So whenever you're acting in a self-destructive way or feeling emotionally disturbed, look for one of those three musts, and then question, challenge, and dispute those musts. And when you do, underneath all musts are preferences, as I mentioned. Musts come from an escalation of our preferences into absolutes. Once you kick out your musts and shoulds, then you have life-fulfilling human preferences underneath, which lead to motivated, constructive behavior and a fulfilling life.
Now, another hallmark and difference between musts and demands and preferences is that demands always lead to a global evaluation. If I must do well and get approval, and I don't, I'm no good - a global evaluation. If you treat me poorly and you must not, you're no good - another global evaluation. Or if life goes poorly, as it must not, life is no good. So another problem with musts and shoulds is those global evaluations; whereas our human, reasonable preferences don't lead to global evaluations if we fail at it, but rather to disadvantages. So in our life there are just advantages and disadvantages, not devils and demons.
So with that outline, people can work at disputing their musts, challenging their musts, kicking out their musts, and reinforcing their preferences, which leads to motivation and an enjoyable life.
David: Okay. Now, your book is rich with case histories for a wide variety of psychological issues. Maybe you can take us through some examples of typical ways you handle certain conditions. For example, you have a chapter on worry.
Michael Edelstein: Right, that's right. Yeah, and there's an interesting case in there about a client I had who avoided eating in restaurants for a very unusual reason, and that is - this is when the AIDS scare was really high - and he was afraid that he would contract AIDS because maybe the chef would cut his finger and get some blood in the food, and then he would eat the food and somehow contract AIDS this way.
So, at first when he started worrying about this, whenever he saw some red in his food, he started worrying "What if it's blood? What if I'm going to get AIDS? I absolutely must have a guarantee that it's not blood and I'm not going to get AIDS." So he had a need for certainty, absolute guarantees, and when you have a need for certainty, you take something that's highly unlikely - that you're going to get AIDS this way - and then you make it into something that is highly likely because it's not satisfied with a 99.999 percent probability you're not going to get AIDS.
You have to have a guarantee that there's a 100 percent probability, and we live in an uncertain world. There's no 100 percent probability of anything. Even death one day they'll invent a gene that they splice into your chromosomes so you live forever; so even that's not an absolute - although it's a high probability these days you're going to die. So when you demand a guarantee, then you have problems, as he did. So he had friends look at the red in his food and guarantee him in his mind that it wasn't blood and then started avoiding restaurants. So that was an interesting case.
And the way I dealt with it is the way I deal with most situations which we already discussed. I helped him identify his must - I must have an absolute guarantee there's no blood in my food - and then I showed him how to challenge, dispute, and contradict that must. It would be preferable to have an absolute guarantee, but such things don't exist in our world, just probabilities. And the probability is there's no blood in my food, and even if there is, I have an even higher probability I'm not going to contract AIDS that way. But I'm almost guaranteed - not quite, because there are no guarantees - that if I keep on demanding certainty, I'm just going to make myself anxious and limit my life. So I taught him the three-minute exercises, and he worked on those, changed his thinking, and then was able to eat in restaurants like normal people.
David: Great. Now, low self-esteem is a very widespread issue and something that you've written about. You refer to the "feel good about yourself" trap. How is that a trap?
Michael Edelstein: Well, not only is it a trap, but it's a very common trap that most therapists unfortunately teach, because if you're depressed, then there's a good chance you're depressed because you have low self-esteem. Depression and low self-esteem are practically synonymous; they overlap to a great extent. So a therapist's approach to this is to try to give you high self-esteem by telling you how wonderful you are or finding some of your good traits and highlighting those.
But that's a trap because both high and low self-esteem are based on the same mistake, and that is self rating - rating your total self based on your behavior or other people's opinions. It's saying that if I do well and people like me, I'm a good person, I have high self-esteem; or if I do poorly or people reject me, I am a bad person or a loser, worthless, and therefore I have low self-esteem. But the truth is, realistically, you're never a good person or a bad person. You never only and always act well, no matter how well you do at times. And you never only and always act poorly if you do poorly at times. You're always just an imperfect human who acts imperfectly.
So I teach my clients how to go for unconditional self-acceptance rather than high self-esteem, which is flawed and a double-edged sword because that leads to low self-esteem when you do poorly. And unconditional self-acceptance says I am a human with goals, and sometimes I achieve my goals, sometimes I don't. And when I achieve my goals, I'm not a good person; I'm just the same imperfect human who acts imperfectly; and similarly, when I don't achieve my goals. So you can always accept yourself unconditionally, never put yourself up when you do well or put yourself down when you do poorly, and that dispenses with the self-esteem problem. Self-esteem is really irrelevant to your life.
So the question arises: how do you enjoy life if you don't think of yourself as a good person? How are you motivated if you're not motivated to be a good person? And the answer is by having goals, establishing goals, defining goals into your life, passions, interests, life sustaining goals, and working toward them. And the process of working toward them - as long as you don't have your ego involved - generally is a satisfying process, although it has its frustrations along the way. And then if you achieve your goal, that also is very satisfying, so that's where we get our pleasure, our fulfillment, our passion, and enjoyment in life - setting goals and working toward them.
David: Okay, well, that makes sense to me. What about people who are struggling with anger issues?
Michael Edelstein: Anger is another concept, or another emotion, that I have an unconventional view about - and again I got all this from Albert Ellis - that anger is always unjustified. Some therapists will say there's reasonable anger or healthy anger, and unreasonable or unhealthy anger, but I see all anger as emotionally destructive. A writer, Harry Emerson Fosdick, said, "Anger is like burning down your house to get rid of a rat." In other words, you rip yourself up inside and you eat your insides out when you get angry, and it doesn't do you any good and it usually alienates the other person.
And anger, philosophically, is commanding and demanding, running the universe. It's musts; it's that second must that I mentioned: you must do my bidding; you must treat me well and kindly and understandingly and reciprocally. And if you don't, you're no good; you deserve to roast in hell, and I just appointed myself your roaster. So it's really godlike, grandiose, to get angry at people, and it leads to poor results.
So the solution to anger isn't lying down and being passive and being a doormat and letting people walk all over you because, as we've been saying, underneath these musts - you must treat me well - are our preferences. So you get rid of your musts and you still have a preference, so if your partner is treating you poorly, disrespecting you, you still have a strong preference, which would be good for you to assertively discuss and say, "I have a strong preference that you not call me names, that you not treat me that way. How do you feel about that?" So you're in better shape to get what you want because you present it in a more reasonable way that other people are more willing to listen to, rather than in an angry, condemning way.
David: Okay. Now, I notice in your bio that you do work with addiction, with an addiction self-help group. What's your take on AA, and how does your approach differ?
Michael Edelstein: That's right, David, addictions is one of my specialties. And my take on AA is that some people do improve as a result of their involvement with AA, and I think the main reason they improve is because of the sponsorship that AA has, where you get a sponsor usually when you join AA, someone you can call when you have an urge to drink or an urge to use, and then they talk to you and the urge subsides for a while. So that's useful; it's sort of a momentary thing. It doesn't teach you to be autonomous and help yourself. You're sort of reliant on other people and this person, and you're certainly reliant on the Twelve Step meetings because they encourage 90 meetings in 90 days and things like that, which is quite a dependence on the meetings.
Whereas the REBT approach teaches you to be your own therapist, to identify the musts and shoulds that lead to your addictions, which are often "I must satisfy my craving for alcohol right now, and if I don't, I can't stand it. I have to be miserable," or "I must have that piece of chocolate because I want it, and it's the end of the world if I don't get what I want." So, again, there are these musts and shoulds that cause addictions. And the solution isn't 90 meetings in 90 days, but it's identifying those musts and challenging, questioning, disputing, and contradicting them, and changing your entire philosophy, your way of looking at temptation, cravings, and escape. So you look at that as a preference and then you can act on your greater preference not to use, not to get high, and not to drink if that's your goal. And use more constructive ways to achieve your goals.
Another big problem I have with the Twelve Steps, in addition to creating that dependency, is the Twelve Steps themselves, especially Step Number One, which says "I admit I am powerless over alcohol," and that doesn't make much sense to me at all. Obviously you're not powerless over alcohol because you're the one who decided to buy the wine and pour it in your glass and drink it. The wine didn't force you to do it. So you have the power to drink, so if you have the power to drink, you have the power not to drink. So the problem isn't that you're powerless, the problem is that you're using the power you have in a destructive way, and the goal is to use that power you have in a constructive way - not to say you're powerless and you need a higher power to lean on to change your life.
David: I think AA has been very successful in convincing us, the society kind of at large, that alcoholics are powerless and that that's the only approach. I gather you found some success in your approach?
Michael Edelstein: Oh, yes, not only in doing therapy individually with people, but also as you mentioned, I have this group called SMART Recovery. I'm the professional advisor in San Francisco, and it's actually not my SMART Recovery; it's an international group, and SMART stands for Self Management And Recovery Training. We're self-help groups for people overcoming addictions, and you can find the SMART Recovery meeting in your area by going to SMARTRecovery.org, and they list all the SMART Recovery meetings around the world. And if you're in San Francisco, you can find information on my website, which is threeminutetherapy.com. Three is spelled out and threeminutetherapy is all one word. And I have some pages on SMART Recovery, the philosophy, and our meetings in San Francisco.
David: And I'll be sure to put a link to your website in our show notes, so if people go to the show notes on wisecounselpodcast.com, they'll find a link to your site there as well. Now, what about suicide? I recall Ellis having a very unconventional approach to suicide. If I recall correctly, he saw suicidal people as thinking others would feel sorry that they had killed themselves, so he would - I don't know - kind of mock them, telling them that he wouldn't miss them at all. Do I have that right?
Michael Edelstein: [Laughs] That's funny. I didn't know about that.
Michael Edelstein: But the main problems with suicide are a few: one is that people feel inadequate and insecure and they can't make it in life, so they might as well give up and kill themselves. Another reason is to escape the pain. They're in emotional pain, which is self-created because they're putting themselves down or they're saying life is horrible and I can't stand it, and it's an escape from this self-created emotional pain. And a minor reason with some might be that others will feel sorry for them, but when it is a reason, it's often a secondary reason.
So the solution to suicide, as with these other problems we've been mentioning, is for people to get in touch with the musts and shoulds that's creating their emotional pain - not escaping it through death - but the irrational beliefs, the thoughts in their head. And it's only thoughts in their head that's creating emotional pain. And questioning, challenging, and disputing it - what's the evidence I must do well, and because I'm failing at most things in my life, I'm a bad person; or what's the evidence I must not have this emotional pain, and because I do, the only relief is through death and escape - and seeing that the musts don't make sense. There are no musts. It's preferable not to have the emotional pain, but escape is hardly a good solution. The better solution is stop creating it by challenging the musts.
David: Towards the end of your book, or maybe at the very end, you kind of bring up some of the traditional critiques that other therapists have brought against the REBT approach. And I have no doubt that your book and your work has been helpful to many people. At the same time, I have difficulty embracing REBT as the cure. I don't know if you think it's "the" cure for everything or not. Let me just ask you, do you think this is like the only approach that works?
Michael Edelstein: Well, that's a good question, and there are a few answers to that. I think that the theory is the only theory that works, that the reason people get better in their life in dealing with emotional problems is because they change their thinking. No matter what other therapists say - the reason is like because we just uncovered your childhood; now you know why you feel this way, because your mother looked at you cross-eyed when you were three years old, and that's why you're feeling better - really, what people are doing is changing their thinking, and they're thinking, well, I'm really not inherently bad. It was my mother who told me this, and I believed this, and I don't have to believe that I'm a bad person, etc.
So they change their thinking, which is one of REBT's insights - you change your thinking and then you change your emotions and behavior. So they change their thinking. But I don't think REBT is the only thing that leads people to change their thinking. There are all kinds of things that may not even be therapy at all: just reading books or thinking about their thinking; thinking about things; getting more mature or having talks with wise friends; or trial and error. Those kinds of things could help people change their thinking. Or, as I just illustrated with psychoanalysis, you change your thinking in a rather indirect way.
But the thing I like about REBT is it's a very direct identification of irrational beliefs and ways to change your thinking. And normally the average duration of therapy with my clients is 8 to 10 sessions, and that's not counting people who just read my book and send me emails from around the world and tell me how helpful the book was in dramatically improving their life. So it's a very efficient form of therapy and it doesn't go into irrelevant things like your childhood relationship with your parents, things like that, but goes to the heart of the matter and shows you how to change things. So in that way, I think it's a very effective and direct form of therapy.
David: Well, I like your answer because I know that I see overlap as I look at other approaches and I see that what you say about getting a different perspective, a different take, thinking about your life differently, is something that can come about in a variety of ways.
Michael Edelstein: Oh, another way, Dave, that other forms of therapy might be more helpful to some people than REBT is some people just don't like the idea that their emotions can be pigeon-holed into just some irrational beliefs. That doesn't appeal to their esthetics or personality styles. So they're not going to try REBT. It's going to turn them off because it's sort of scientific, and they're going to look for a therapist who seems more compassionate, more warm, and is more touchy-feely kind of therapy, and they'll be more open to that, so that might be more helpful.
On the other side, I think a lot of these therapies could be harmful in some of the ways I mentioned. It teachers high self-esteem, which is barking up the wrong tree because it's still teaching people to rate themselves, and it teaches that anger can be healthy, which also doesn't help people get over their commanding, dictating philosophy. And it teaches that your problems come from your childhood, which has been disproved time and again by research which shows that there's a large genetic component, a large genetic influence in people's emotional problems. So there are a number of harmful things about other types of therapy, as well as some of their benefits.
David: Yeah. I'm probably in that camp - that warm, fuzzy camp - to some extent, even though I agree with a lot of the points that you've made. But sort of dispositionally I think I'm in one of those camps. I think that human beings are complex and life is complex and that no single approach is going to work for everybody, which I think you've pretty much just agreed to. And I do have a bit of a problem with - you're fairly dismissive of psychoanalysis, as was Ellis, who started as an analyst as you pointed out. And in support of that position, you cite a 1977 paper, but that seems to discount the ways in which psychoanalytic thought and practice have evolved over the years, and I would refer you to a recent 2010 paper in The American Psychologist by Dr. Jonathan Shedler, a psychiatry professor at the University of Colorado Medical School.
Michael Edelstein: How do you spell Shedler?
David: Shedler. S-H-E-D-L-E-R. You can also listen to my interview with him on Shrink Rap Radio. And he published this paper on the efficacy of psychodynamic therapies, and basically he did a meta-analysis and found psychodynamic therapies to be as effective as CBT.
Michael Edelstein: Oh, I'd like to hear that interview.
David: Yeah, great. Yeah, take a listen and then you can get back to me and let me know your thoughts, or you can post your comments on the site actually.
Michael Edelstein: Okay.
David: So this is probably a good place for us to wrap it up. As we wind down here, I wonder if there's anything else that you'd like to say.
Michael Edelstein: Yes, and that is I would recommend that people at least take a look at my website, and I have many chapters from my book on my website, and many articles, and also my email address and phone number. If you have any questions, feel free to email me or call me, and I'll be happy to answer your questions. And the main proof is in you trying it, and I always recommend to my clients don't believe what I say just because I say it; try it yourself. In just a few weeks, if you really do the three-minute exercises and question your musts and shoulds, you'll see some changes in your thinking and in your emotions, so give it a try, and I think that most people who give it a try will find it very rewarding.
David: Okay, well, Dr. Michael Edelstein, thanks for being my guest today on Wise Counsel.
Michael Edelstein: Oh, thank you very much, Dave, for having me on.
David: I hope you enjoyed this conversation with Dr. Michael Edelstein. I doubt you could get a better introduction to rational emotive behavior therapy from Albert Ellis himself. Given the young age that Dr. Edelstein began his work with Ellis and their long association, and the fact that both are native New Yorkers, I guess I shouldn't be surprised that Dr. Edelstein sounds and feels so much like Albert Ellis. In fact, after the interview was over, I somewhat jokingly remarked that I had the sense that Dr. Edelstein was channeling Dr. Ellis.
Dr. Edelstein's book is very much intended to be a self-help book, and evidently it has served that purpose for many people ever since its publication in 1997. So, as Dr. Edelstein suggested, if you're looking for help or self-help, his book is a small investment and what have you go to lose? And you can find chapters from the book, as well as other useful material, on his site at www.threeminutetherapy.com.
You've been listening to Wise Counsel, a podcast interview series sponsored by Mentalhelp.net. If you found today's show interesting, we encourage you to visit Mentalhelp.net, where you can add a comment or question to this show's web page, view other shows in the series, or simply page through the site, which is full of interesting mental health and wellness content. Access the show's page and show archive information via the podcast box on the Mentalhelp.net home page.
If you like Wise Counsel, you might also like Shrink Rap Radio, my other interview podcast series, which is available online at www.shrinkrapradio.com. Until next time, this is Dr. David Van Nuys, and you've been listening to Wise Counsel.
Michael R. Edelstein, Ph.D. is a clinical psychologist. He has both an in-person and telephone therapy practice. Dr. Edelstein has appeared on over 300 radio shows, lectures regularly, and trains professionals. He was awarded "Author of the Year" by the National Association of Behavior and Cognitive Therapists for his 1997 book, Three Minute Therapy (with David Ramsay Steele, Ph.D). Dr. Edelstein is also a past president of the Association of Behavior and Cognitive Therapists. In addition, he trains volunteers at the National Save-A-Life League and Community Sex Information, both in New York City. He is also the professional advisor for SMART Recovery, an addiction self-help group in San Francisco. You can find more information about Dr. Edelstein and Rational Emotive Behavior Therapy at: www.ThreeMinuteTherapy.com.
REBT- really? - James Alexander - Dec 6th 2012
Its a pity i only just now found this podcast- not sure if anyone is still reading comments from old programs? My experience is an exact inverse of Ellis. I was trained in RET and CBT, and over the course of 25 years of practice, have slowly swung around to depth psychology approaches (in which i include EMDR). I had many reasons for this- firstly, my observation that any time RET/CBT worked, it was largely a placebo effect derived from creating an expectation of change. Many clients will eventually give in and start parroting the standard RET rhetoric, but it will only work if the therapist has succeeded in creating an expectation of change- then the clients own momentum for positive change takes over, and the RET rhetoric becomes quite irrelevant. Secondly, it is a somewhat abusive mind-set: I am the therapist who is rational and knows all/you know nothing/learn to think like me and you will become happy. Really?! (Not to mention insulting and disempowering). The mind-set that people are being trained into is not much more than technological rationalism (aka: university induced autism). If these people were naturally and spontaneously like Ellis, they'd be called autistic. Pay someone loads of money to speak like it, and some choose to call it therapy. The fact is that the standard cognitive model of emotions is simply wrong. There are decades of neuroscience research now which clearly demonstrates that there is no neat separation of thoughts from feelings, or that thoughts create feelings. This is simply folk psychology at its worst, and has no emperical basis. Supporters of this model of emotions really need a decent education in the neuroscience of emotions. There, you will learn the reality of our emotions, and see that snappy simplistic ABC models are simply the imaginings of some therapists/marketeers. Can anyone seriously suggest that childhood and adolescent experiences do not contribute to why a person may feel nervous in approaching women, for example? Where is the understanding/appreciation of attachment issues, early traumas, adolescent experiences of rejection, etc? To ignore and exclude these is to just reduce your theorising to arid nonsense (and ignorance). Despite all that is wrong with the whole RET/CBT paradigm, people will often get better as a result (I saw this sometimes when i was an enthusiastic RET practitioner), but this has more to do with the inherent desire to improve that exists within the client than with anything that the therapist has done (other than create an expectation of change). RET/CBT zealots really need to revisit what decades of research says contributes to positive outcomes (see Scott Miller). I thought Dr Dave was incredibly patient and polite in this interview- a credit to him, when i imagine deep down (gee- hang on- is there actually a 'deep down'?) he may have been either laughing or crying at what was being said. Who, indeed, needs to join the 21st century? The world is big enough for us to all cope with all types of approaches, but when RET/CBT zealots start insulting all others with appeals to join the 21st century, then i really believe it is time they acquainted themselves with much of the research (from psychology as well as neuroscience) that has been done since Ellis began his campaign of rhetoric in the 1950's. They will find that many of the notions which they are either highly critical or ingorant of in fact have a great deal of research based evidence in their favour- even depth psychology approaches.
Russ is wrong - Herb - Mar 15th 2012
Russ, it's 2012. Psychoanalysis is over. Shedler's bizarre meta-analysis proves nothing and you should know that. If you would bother to read a book about CBT you would find your questions anwered. The debate is settled and, sorry, psychoanalysis lost. Welcome to the 21st century.
thinking exercises - Russ - Mar 26th 2011
I wonder if Dr. Edelstein is familiar with Dr. Jonathan Shedler's study which very strongly demonstrates the efficacy of psychodynamic therapies over CBT.
If one's thinking (and of course one's feeling) is bound up in deep-seated, often unconscious feelings such as rage, hurt or unfelt sadness, are thinking exercises really effective? Or does CBT just not believe in the idea of unconscious processes?
Dr. Dombeck's Note: The thinking exercises that comprise the various forms of CBT are *highly* effective. Literally hundreds of studies have established that. Other techniques can be effective too, including many dynamic psychotherapy techniques. All the parts are linked together; if you manipulate one part, you end up effecting the whole system.